Clinic of Orthopedics and Trauma Surgery, Heidelberg University Hospital, Schlierbacher Landstr. 200a, 69118 Heidelberg, Germany.
Clinic of Orthopedics and Trauma Surgery, Heidelberg University Hospital, Schlierbacher Landstr. 200a, 69118 Heidelberg, Germany; Schwaebisches Gelenkzentrum Stuttgart, Hohenheimer Str. 91, 70184 Stuttgart, Germany.
Orthop Traumatol Surg Res. 2021 Jun;107(4):102896. doi: 10.1016/j.otsr.2021.102896. Epub 2021 Mar 19.
The objective of this prospective cohort study was the assessment of short-term outcome results of shoulder hemiarthroplasty (HA) using pyrolytic carbon (PC) heads. PC has been introduced as a new material to avoid surgical revision due to glenoid erosion after HA. Glenoid erosion due to the use of metallic heads is known to reduce durability.
HA using PC heads shows comparable or better radiographic and clinical outcome compared to the conventional HA using metallic heads in the short-term.
This study was conducted as a single center prospective cohort follow-up study including a total number of 16 consecutive HA with PC heads. Inclusion criteria were indication for HA, an intact rotator cuff, no proximal humeral fractures in patient's history and age>18years. Mean age at the time of arthroplasty was 52.8±10.8years. The mean follow-up was 24.3±8.1months. Baseline and follow-up Numeric Rating Scale (NRS), Constant Scores (CS), Range of Motion (ROM) and radiographs were assessed.
At a mean follow-up of 24.3months the mean CS (p<0.001), mean NRS (p<0.001) and mean ROM (p<0.05) improved statistically significant. Subgroup analysis revealed no differences between subgroups (sex, age, diagnosis, and handedness). Survival rate was high (94.1%). One periprosthetic fracture occurred as the only complication during follow-up. Radiographs showed glenoid erosion in one case and subacromial space reduction in two cases.
PC heads in HA show satisfying short-term results at a mean follow-up of two years, which are comparable to those of conventional HA. The clinical improvements were highly significant with good implant survival. However, long-term follow-up results are necessary, especially compared to conventional HA.
IV; observational therapeutic cohort study.
本前瞻性队列研究的目的是评估使用热解碳（PC）头的肩关节半髋关节置换术（HA）的短期结果。PC 已被引入作为一种新材料，以避免因 HA 后肩胛盂侵蚀而进行手术翻修。已知使用金属头会导致肩胛盂侵蚀，从而降低耐用性。
与使用金属头的传统 HA 相比，使用 PC 头的 HA 在短期内具有相似或更好的影像学和临床结果。
这项研究是作为一项单中心前瞻性队列随访研究进行的，共纳入 16 例连续使用 PC 头的 HA 患者。纳入标准为 HA 的适应证、完整的肩袖、患者病史中无肱骨近端骨折和年龄>18 岁。关节置换时的平均年龄为 52.8±10.8 岁。平均随访时间为 24.3±8.1 个月。评估了基线和随访时的数字评分量表（NRS）、常数评分（CS）、活动范围（ROM）和 X 线片。
在平均 24.3 个月的随访中，CS（p<0.001）、NRS（p<0.001）和 ROM（p<0.05）的平均值均有统计学显著改善。亚组分析显示，在亚组（性别、年龄、诊断和惯用手）之间没有差异。生存率高（94.1%）。在随访期间仅发生 1 例假体周围骨折作为唯一并发症。X 线片显示 1 例肩胛盂侵蚀和 2 例肩峰下空间缩小。
在平均两年的随访中，HA 中的 PC 头显示出令人满意的短期结果，与传统 HA 相当。临床改善非常显著，具有良好的植入物存活率。然而，需要进行长期随访结果，特别是与传统 HA 相比。
IV；观察性治疗队列研究。
